{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:49:05Z","timestamp":1787060945794,"version":"build-2736575974"},"reference-count":62,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFB"],"abstract":"<jats:p>Background: Implant material may influence interfragmentary mechanics in medial malleolar (MM) fracture fixation. This study aimed to compare stainless steel, titanium, magnesium, and PLGA screws under identical conditions using finite element analysis (FEA). Methods: A CT-based ankle model with a unilateral oblique MM fracture (\u03b8 = 60\u00b0 to the medial tibial plafond) was fixed with two parallel M4 \u00d7 35 mm screws placed perpendicular to the fracture plane (inter-axial distance 13 mm). Contacts were defined as nonlinear frictional, and each screw was assigned a pretension force of 2.5 N. Static single-leg stance was simulated with physiologic tibia\/fibula load sharing. Four scenarios differed only by screw material. Primary outputs were interfragmentary micromotion (maximum sliding and gap). Secondary measures included fracture interface contact\/frictional stresses, screw\/bone von Mises stress, global construct displacement, and average tibiotalar cartilage contact pressure. Results: Interfragmentary micromotion increased as screw stiffness decreased. Maximum sliding was 32.2\u201333.8 \u00b5m with stainless steel\/titanium, 40.4 \u00b5m with magnesium, and 65.0 \u00b5m with PLGA; corresponding gaps were 31.2\u201332.0 \u00b5m with stainless steel and titanium, 31.2 \u00b5m with magnesium, and 54.1 \u00b5m with PLGA, respectively. Interface stresses followed the same pattern: contact pressure (3.18\u20133.24 MPa for stainless steel\/titanium\/magnesium vs. 4.29 MPa for PLGA); frictional stress (1.46\u20131.49 MPa vs. 1.98 MPa). Peak screw von Mises stress was highest in stainless steel (104.1 MPa), then titanium (73.4 MPa), magnesium (47.4 MPa), and PLGA (17.9 MPa). Global axial displacement (0.26\u20130.27 mm) and average tibiotalar cartilage contact pressure (0.73\u20130.75 MPa) were essentially unchanged across materials. All conditions remained below commonly cited thresholds for primary bone healing (gap &lt; 100 \u00b5m); however, PLGA exhibited a reduced safety margin. Conclusions: Under identical geometry and loading conditions, titanium and stainless steel yielded the most favorable interfragmentary mechanics for oblique MM fixation; magnesium showed intermediate performane, and PLGA produced substantially greater micromotion and interface stresses. These findings support the use of metallic screws when maximal initial stability is required and suggest that magnesium may be a selective alternative when reducing secondary implant removal is prioritized.<\/jats:p>","DOI":"10.3390\/jfb17020059","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T12:41:16Z","timestamp":1769431276000},"page":"59","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medial Malleolar Fracture Fixation with Stainless Steel, Titanium, Magnesium, and PLGA Screws: A Finite Element Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5872-5758","authenticated-orcid":false,"given":"Mehmet Melih","family":"Asoglu","sequence":"first","affiliation":[{"name":"Orthopedics and Traumatology Clinic, Private Metrolife Hospital, Sanliurfa 63320, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7472-3303","authenticated-orcid":false,"given":"Volkan","family":"K\u0131z\u0131lkaya","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Clinic, Private Metrolife Hospital, Sanliurfa 63320, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3666-1084","authenticated-orcid":false,"given":"Ali","family":"Levent","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Clinic, Private Metrolife Hospital, Sanliurfa 63320, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8154-6993","authenticated-orcid":false,"given":"Huseyin Kursat","family":"Celik","sequence":"additional","affiliation":[{"name":"Department of Agricultural Machinery and Technology Engineering, Akdeniz University, Antalya 07070, Turkey"},{"name":"Engineering Department, Lancaster University, Lancaster LA1 4YW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7679-9635","authenticated-orcid":false,"given":"Ozkan","family":"Kose","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Antalya Training and Research Hospital, University of Health Sciences, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4568-316X","authenticated-orcid":false,"given":"Allan E. W.","family":"Rennie","sequence":"additional","affiliation":[{"name":"Engineering Department, Lancaster University, Lancaster LA1 4YW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bergh, C., Wennergren, D., M\u00f6ller, M., and Brisby, H. (2020). Fracture incidence in adults in relation to age and gender: A study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area. 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